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How to Optimize Your Remote Therapy Sessions and Keep Clients Engaged

How to Optimize Your Remote Therapy Sessions and Keep Clients Engaged

By Wyatt R. Evans, PhD, ABPP

Coming into contact with aversive internal experiences—thoughts, emotions, sensations—is an essential part of healing through therapy. Therapists work with clients to raise awareness of experiential avoidance and disengage costly control strategies. This is accomplished via exercises targeting openness to internal experiences. When conducting therapy via telehealth, therapists may find their repertoire of experiential exercises becomes truncated by remoteness, technological limitations, or access to resources. On the other end of the line, these same factors may enable or exacerbate experiential avoidance in our clients.  

Therapists should be both flexible and steadfast when conducting therapy remotely. We must remain committed to therapeutic processes that work, while adapting our procedures to new circumstances. However, like our clients, we have minds that may seek to allay anxiety, frustration, or self-consciousness related to this new context for therapy in unworkable ways. Rather than collude with a control agenda that may exploit the disconnect imposed by telehealth as a means of avoidance, therapists should model openness to experience and remain committed to high-quality, process-based care. 

Several practical strategies may help therapists navigate the shift to remote therapy or enhance their telehealth practice. First, be proactive. Review your repertoire of tools and techniques for engaging therapeutic processes. Identify which would be difficult or impossible via video or phone. Then, make adaptations. Second, be intentional. Encourage your clients (and yourself) to dedicate time, space, and energy to the therapy. Clients ought not complete sessions while engaged in other tasks (e.g., work, childcare). Therapists, rather than engaging urges to multitask, should work to deepen the connection to the patient. Finally, be compassionate. Glitches, freezes, and dropped calls can short-circuit some of the observational skills we have honed as therapists. Our attention skills are stretched in different ways. If you notice frustration, agitation, or exhaustion, do so mindfully and with self-kindness. Our common humanity connects us, even from afar. 

Book Titles: The Moral Injury Workbook 

sunset showing various shades of the skyWyatt R. Evans, PhD, is a board-certified clinical psychologist with the VA North Texas Health Care System, and therapist in private practice in the Dallas-Fort Worth area. His primary areas of expertise are resilience and post-traumatic stress, including moral injury. He is committed to advancing interventions, especially acceptance and commitment therapy (ACT), to promote recovery and enhance resilience for service members, veterans, and others highly affected by trauma.

Robyn D. Walser, PhD, is director of TL Consultation Services, codirector of the Bay Area Trauma Recovery Clinic, staff at the National Center for PTSD, and an associate clinical professor at the University of California, Berkeley. As a licensed clinical psychologist, she maintains an international training, consulting, and therapy practice. She is an expert in ACT, has coauthored six books on the subject, and is author of The Heart of ACT.

Kent D. Drescher, PhD, is a clinical psychologist (retired) who provided clinical services, education, and research as a staff member with the National Center for PTSD for more than twenty-seven years. His primary areas of expertise include the intersection of trauma and spirituality and moral injury. He has been an early advocate for the use of ACT for veterans struggling with moral challenges following military service.

Jacob K. Farnsworth, PhD, is a licensed clinical psychologist with the VA Eastern Colorado Health Care System, specializing in trauma and substance use disorders. He is codeveloper of the ACT for moral injury intervention, and his writing and research has focused on translating cutting-edge research into innovative and effective treatments for moral injury.